title: Musculoskeletal physical outcome measures in individuals with tension-type headache: a scoping review.
abstract: BACKGROUND
  Individuals with tension-type headache (TTH), in addition to headache pain, typically suffer from pericranial muscle tenderness and increased cervical muscle tone. Physical and physiological outcomes related to musculoskeletal function, however, are not commonly assessed in clinical studies and not systematically proposed as outcome measures in headache-related practice guidelines.
  
  
  OBJECTIVE
  To review which musculoskeletal outcomes are used in the clinical assessment of patients with TTH and which are associated with headache pain and related dysfunction.
  
  
  METHODS
  Literature searches were performed in MEDLINE, PubMed, the Cochrane databases and EMBASE using terms relating to musculoskeletal physical outcomes in TTH.
  
  
  RESULTS
  Twenty-six studies met selection criteria. Physiological outcomes typically reported in laboratory studies were trigger points, pressure pain threshold, range of motion and tenderness. A greater number of trigger points and lower pressure pain threshold were reported in patients with episodic TTH in comparison with healthy subjects. Individuals with chronic TTH, when compared with non-headache controls, consistently showed a greater number of trigger points, a lower value of pressure pain threshold and a more severe forward head posture.
  
  
  CONCLUSIONS
  Musculoskeletal outcomes, such as trigger points, pressure pain threshold and forward head posture should inform TTH pathophysiology, diagnosis and interdisciplinary patient care.
authors.affiliation: Université du Québec à Trois-Rivières, Canada.
authors.forename: Jacques
authors.initials: J
authors.lastname: Abboud
authors.forename: Andrée-Anne
authors.initials: AA
authors.lastname: Marchand
authors.forename: Karin
authors.initials: K
authors.lastname: Sorra
authors.forename: Martin
authors.initials: M
authors.lastname: Descarreaux
mesh_terms: D006801:Humans; D009209:Myofascial Pain Syndromes / Q000150:complications* / Q000175:diagnosis*; D018781:Tension-Type Headache / Q000150:complications* / Q000175:diagnosis*
keywords: Primary headache; pain; pericranial; spine